Palliative Care — A Shifting Paradigm — NEJM

"....Despite the increasing availability of palliative care services in U.S. hospitals and the body of evidence showing the great distress to patients caused by symptoms of the illness,3 the burdens on family caregivers,4 and the overuse of costly, ineffective therapies during advanced chronic illness,5 the use of palliative care services by physicians for their patients remains low. Physicians tend to perceive palliative care as the alternative to life-prolonging or curative care — what we do when there is nothing more that we can do — rather than as a simultaneously delivered adjunct to disease-focused treatment.6...."